Preventing ventilator-associated pneumonia: an evidence-based approach of modifiable risk factors

Seminars in Respiratory and Critical Care Medicine
Warren Isakow, Marin Kollef

Abstract

There is considerable evidence to suggest that specific interventions can be effectively employed to prevent hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). These interventions consist of pharmacological and nonpharmacological strategies that focus on prevention of aerodigestive tract colonization and the prevention of aspiration of contaminated secretions, the major pathogenetic mechanisms leading to HAP. Important components of effective preventive strategies focus on basic infection control principles like handwashing, adequate intensive care unit (ICU) staff education, and optimal resource utilization. Measures to prevent HAP/VAP extend into all aspects of daily intensive care practice, including antibiotic selection and duration of use, preferred routes of intubation, limitation of sedation, protocolized weaning, optimal use of noninvasive mask ventilation, patient positioning, ventilator circuit management, transfusion practices, nutritional support issues, stress ulcer prophylaxis, and glycemic control. Local programs encompassing these interventions should be applied at a multidisciplinary level, involve all caregivers, and include local surveillance programs for antibiotic-resistant bacteri...Continue Reading

Citations

Jun 6, 2007·Intensive Care Medicine·Elpis GiantsouKonstantinos Manolas
Jan 18, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ilker UçkayDidier Pittet
Mar 17, 2012·Critical Care : the Official Journal of the Critical Care Forum·Miguel R GonçalvesJosé Artur Paiva
Nov 4, 2009·Critical Care : the Official Journal of the Critical Care Forum·Aimilia PelekanouEvangelos J Giamarellos-Bourboulis
Mar 27, 2007·Intensive Care Medicine·Jordi RelloAlejandro Rodriguez
Oct 21, 2016·Systematic Reviews·Nicola MackintoshJane Sandall
Mar 28, 2009·Critical Care Medicine·Lars Heslet
Apr 2, 2008·Critical Care Medicine·David Gilbert
Mar 12, 2009·Current Opinion in Pulmonary Medicine·Marcelo CortiKumiko Eiguchi

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